Publication: Pregnancy related complications in women with hypertrophic cardiomyopathy
Authors
Thaman, R. ; Varnava, A. ; Hamid, M. S. ; Sachdev, B. ; Firoozi, S. ; Condon, M. ; Gimeno Blanes, Juan Ramón ; Murphy, R. ; Elliott, P.M. ; McKenna, W.J.
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Facultades de la UMU::Facultad de Medicina
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Publisher
BMJ Publishing Group
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DOI
https://doi.org/10.1136/heart.89.7.752
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info:eu-repo/semantics/article
Description
Abstract
Objectives:To determine whether pregnancy is well tolerated in hypertrophic cardiomyopathy.Setting:Referral clinic.Design:The study cohort comprised 127 consecutively referred women with hypertrophic cardio-myopathy. Forty (31.5%) underwent clinical evaluation before pregnancy. The remaining 87 (68.5%)were referred after their first pregnancy. All underwent history, examination, electrocardiography, andechocardiography. Pregnancy related symptoms and complications were determined by questionnaireand review of medical and obstetric records where available.Results:There were 271 pregnancies in total. Thirty six (28.3%) women reported cardiac symptoms inpregnancy. Over 90% of these women had been symptomatic before pregnancy. Symptoms deterio-rated during pregnancy in fewer than 10%. Of the 36 women with symptoms during pregnancy, 30had further pregnancies. Symptoms reoccurred in 18 (60%); symptomatic deterioration was notreported. Heart failure occurred postnatally in two women (1.6%). No complications were reported in19 (15%) women who underwent general anaesthesia and in 22 (17.4%) women who received epi-dural anaesthesia, three of whom had a significant left ventricular outflow tract gradient at diagnosisafter pregnancy. Three unexplained intrauterine deaths occurred in women taking cardiac medicationthroughout pregnancy. No echocardiographic or clinical feature was a useful indicator of pregnancyrelated complications.Conclusions:Most women with hypertrophic cardiomyopathy tolerate pregnancy well. However, rarecomplications can occur and therefore planned delivery and fetal monitoring are still required for somepatients.
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Citation
Heart, 2003, Vol. 89, pp. 752–756
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